(1036) Impact of the COVID-19 Pandemic on Presentation of Acute Mastoiditis at a Pediatric Tertiary Care Center

Introduction: During the COVID-19 pandemic, there was significant reduction in the diagnosis and treatment of, and hospital admission for, acute otitis media and its complications such as acute mastoiditis. In the period since social distancing restrictions were lifted in 2022, our institution observed what was felt to be an increase in complicated pediatric infections requiring surgical intervention, including mastoiditis and sinusitis. The aim of this study was to explore the impact of the COVID-19 pandemic on the rates and complications of pediatric mastoiditis.

Methods: Patients under 18 years of age diagnosed with mastoiditis between the years of 2015 and 2023 were included in this retrospective cohort study. Cases were divided into “pre-pandemic,” “intrapandemic,” and “post-pandemic” periods. Overall case numbers, patient demographics, and rates of complications were compared between the three groups.

Results: Similar rates of complicated mastoiditis were observed between pre and post-pandemic groups (34% and 35%, respectively), with lower rates observed in the intrapandemic period (27%). There were significant differences observed in length of hospital stay (p = 0.005), number of antibiotics prescribed while inpatient (p = 0.039), and number of antibiotics prescribed at discharge (p = 0.04) between pre and post-pandemic patients. Similar rates of overall complications and operative procedures between the three groups were observed, though there were significantly higher rates of venous sinus thrombosis (38.1% vs 5.9%, p = 0.013) and neurosurgical procedures in post versus pre-pandemic patients (28.6% vs 2.9%, p = 0.029).

Conclusions: While there were similar rates of complicated pediatric mastoiditis before and after the COVID-19 pandemic, increases in certain complications such as venous sinus thrombosis and need for neurosurgical procedures, number of antibiotics prescribed at discharge, and length of hospital stay were observed post-pandemic, suggesting a change in pediatric immunity, disease recognition, and/or access to care during this time.